腹腔镜完全腹膜外腹股沟疝修补术460例分析  

Prevention of the complications of totally extraperitoneal inguinal hernia repair:a report of 460 cases

作　　者：周仕海[1] 郭志刚 陈宏[1] 邓辉洲[1] 雒洪志[1] 冯春在[1] 邓庆炎[1] 余元龙[1] 

机构地区：[1]中山大学附属中山医院普外三科,中山528403

出　　处：《中华普通外科学文献（电子版）》2017年第5期332-335,共4页Chinese Archives of General Surgery(Electronic Edition)

摘　　要：目的探讨腹腔镜完全腹膜外腹股沟疝修补术(TEP)并发症发生的原因及预防措施。方法选择2010年1月至2015年12月间在中山大学附属中山医院行TEP手术的460例腹股沟疝患者作为研究资料,分析并发症的发生情况。结果 40例患者术后疝复发5例(1.09%),发生顽固性疼痛6例(1.30%),腹膜分破22例(4.78%),腹股沟区及阴囊血清肿62例(13.48%)。阴囊疝、术中出血量≥5 ml的患者血清肿发生率明显高于非阴囊疝、出血量<5 ml患者,且差异具有统计学意义(χ~2=31.954、4.084,P=0.000、0.043)。结论 TEP是修补腹股沟疝的良好方法,只要正确找到入路平面,认清解剖标志,仔细止血,妥善固定补片,就能有效减少并发症发生。Objective To summarize the reasons and preventions of postoperative complications of totally extraperitoneal inguinal hernia repair （TEP）. Methods A total of four hundred and sixty patients with inguinal hernia underwent laparoscopic TEP from January 2010 to December 2015 in the Affiliated Zhongshan Hospital. Their clinic data and postoperative complications were collected and analyzed retrospectively. Results Recurrence happened in 5 of the 460 cases（1.09%）. There were 6 chronic intractable pains in inguinal region （1.30%）, 22 （4.78%） of peritoneum rupture, 62 （13.48%） of seroma. Patients with scrotal hernia and intraoperative blood loss greater than 5 ml had higher incidence of seroma, the differences were statistically significant （Z2=31.954, 4.084, P=0.000, 0.043）. Conclusions TEP is a good method for repairing inguinal hernia. If we can expand the extraperitoneal space correctly, identify anatomic landmark correctly, stop bleeding carefully, and fix the mesh properly, the complications of TEP will be effectively reduced.

关 键 词：腹腔镜 疝修补术 手术后并发症 疼痛 顽固性 

分 类 号：R656.21[医药卫生—外科学]